cms_GU: 9
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 9 | GUAM MEMORIAL HOSPITAL AUTHORITY | 655000 | 499 NORTH SABANA DRIVE | BARRIGADA | GU | 96913 | 2019-01-30 | 757 | D | 0 | 1 | IS8311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility did not ensure that the resident's was free of unnecessary drugs including drugs used without adequate monitoring. Findings include: 1. Resident 9 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. The medical record revealed that the resident had a [MEDICAL CONDITION] and an indwelling catheter and was described as being a paraplegic. The most recent minimum data set assessment ((MDS) dated [DATE] described the resident has having a BIMS (brief interview of mental status) score of 15 indicating that she had no cognitive impairments. The MDS also noted that she had no [MEDICAL CONDITION], no mood disorders except for poor appetite (or overeating), and was totally dependent on staff for all activities of daily living. A physician's note dated 11/14/18 revealed that the resident had [MEDICAL CONDITION] disorder that was Likely contributing to issues medically; and that she was being followed by a psychiatrist. Review of the medical record revealed that Resident 9 was receiving [MEDICATION NAME] 20 mgs for depression daily. The depression, according to behavior monitoring sheets, was manifested by withdrawal. On 12/20/18, a physician's orders [REDACTED]. Review of monitoring sheets including those completed in (MONTH) (2018), and (MONTH) (2019) revealed that monitoring for withdrawal was not always being conducted on all three shifts, and at times, for several days to a week (12/12/18 - 12/19/18). For days when entries were available, monitoring noted 0 indicating no withdrawal behaviors were observed. In addition, monitoring for side effects was not always being conducted. During the survey, Resident 9 was observed being wheeled to the day room by staff in her bed where she could watch television or interact with other residents who were in the room. In an interview on 1/29/19, the resident stated that she was usually brought to the day room around mid-day because it was good to be out of her room for a while. During an interview on 1/29/18, a pharmacy staff (PH1) stated that Resident 9 was no longer being monitored for withdrawal but for loss of appetite resulting in poor oral intake; which was also why, according to PH1, the [MEDICATION NAME] dose was increased (on 12/20/18). PH1 added that this was discussed in an interdisciplinary team meeting in (MONTH) 2019, that the antidepressant could help stimulate the resident's appetite and improve her food intake. 2. Resident 17 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. The MDS assessment dated [DATE] described the resident as having moderately impaired cognitive skills and that he required extensive assistance for most activities of daily living. The medical record also noted that the resident was speech and hearing-impaired. Review of the medical record revealed that Resident 17 had a physician's orders [REDACTED]. Review of the Medication Administration Record [REDACTED]. Review of behavior monitoring sheets including (MONTH) (YEAR), and (MONTH) 2019 revealed that monitoring (for combativeness) was not always being conducted for days and weeks including on 12/01/18 - 12/14/18 (on the day shift), and from 12/25/18 - 12/31/18 (day shift). In addition, monitoring for side effects was not also always being conducted. During an interview on 1/29/19 regarding the lack of monitoring of problem behaviors and side effects, PH1 stated that it was something that the licensed staff had to be better at. | 2020-09-01 |